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Goldstein A, Commissariat PV, Sullivan KL, Hallowell ES, Davis JD, Margolis SA. Compensatory Strategy Intervention: What Older Patients Want and Why. Arch Clin Neuropsychol 2024:acae023. [PMID: 38520386 DOI: 10.1093/arclin/acae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/30/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE Compensatory strategies can improve performance of instrumental activities of daily living in people with cognitive impairment. This study investigated patient interest in compensatory strategy interventions and preference for various intervention formats. METHODS Semi-structured qualitative interviews with 38 older adults with cognitive impairment queried motivation to improve strategy use and interest in intervention formats/delivery methods. Two coders used thematic analysis to determine rates of interest in each intervention type and explore patient-reported barriers and facilitators to motivation and intervention models. RESULTS Most of the samples reported motivation to enhance compensatory strategy use. Degree of motivation was driven by current experiences with strategy use, perceived benefit of potential changes, intrinsic desire to improve life and self, and current perceived need. The vast majority were interested in hour-long, multi-session, instructor-led interventions. Just over half of the sample was interested in a self-directed virtual program, and just under half was interested in involving family/friends. Facilitators and barriers to interest in intervention formats and delivery methods varied based on participants' previous experiences, preferred learning style, content, and time commitment of the intervention, and perceived current need for intervention. One-fifth of the sample expressed no interest in any intervention type, though they expressed openness to assistance in the future as needed. CONCLUSIONS Older adults with cognitive impairment are generally motivated to enhance their compensatory strategy use. Clinicians/researchers designing compensatory strategy interventions should consider instructor-led formats, present individualized benefits of interventions, and demonstrate the benefits of both preventative and remedial intervention to optimize patient engagement.
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Affiliation(s)
- Allyson Goldstein
- Department of Adult Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI, USA
| | - Persis V Commissariat
- Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Kelli L Sullivan
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Adult Psychiatry and Behavioral Health, Miriam Hospital, Providence, RI, USA
| | - Emily S Hallowell
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Mental Health and Behavioral Sciences, Providence Veterans Administration Medical Center, Providence, RI, USA
| | - Jennifer D Davis
- Department of Adult Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Seth A Margolis
- Department of Adult Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Lesoil C, Bombois S, Guinebretiere O, Houot M, Bahrami M, Levy M, Genthon R, Bozon F, Jean-Marie H, Epelbaum S, Foulon P, Villain N, Dubois B. Validation study of "Santé-Cerveau", a digital tool for early cognitive changes identification. Alzheimers Res Ther 2023; 15:70. [PMID: 37013590 PMCID: PMC10068729 DOI: 10.1186/s13195-023-01204-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/11/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND There is a need for a reliable, easy-to-use, widely available, and validated tool for timely cognitive impairment identification. We created a computerized cognitive screening tool (Santé-Cerveau digital tool (SCD-T)) including validated questionnaires and the following neuropsychological tests: 5 Word Test (5-WT) for episodic memory, Trail Making Test (TMT) for executive functions, and a number coding test (NCT) adapted from the Digit Symbol Substitution Test for global intellectual efficiency. This study aimed to evaluate the performance of SCD-T to identify cognitive deficit and to determine its usability. METHODS Three groups were constituted including 65 elderly Controls, 64 patients with neurodegenerative diseases (NDG): 50 AD and 14 non-AD, and 20 post-COVID-19 patients. The minimum MMSE score for inclusion was 20. Association between computerized SCD-T cognitive tests and their standard equivalent was assessed using Pearson's correlation coefficients. Two algorithms (a simple clinician-guided algorithm involving the 5-WT and the NCT; and a machine learning classifier based on 8 scores from the SCD-T tests extracted from a multiple logistic regression model, and data from the SCD-T questionnaires) were evaluated. The acceptability of SCD-T was investigated through a questionnaire and scale. RESULTS AD and non-AD participants were older (mean ± standard deviation (SD): 72.61 ± 6.79 vs 69.91 ± 4.86 years old, p = 0.011) and had a lower MMSE score (Mean difference estimate ± standard error: 1.74 ± 0.14, p < 0.001) than Controls; post-COVID-19 patients were younger than Controls (mean ± SD: 45.07 ± 11.36 years old, p < 0.001). All the computerized SCD-T cognitive tests were significantly associated with their reference version. In the pooled Controls and NDG group, the correlation coefficient was 0.84 for verbal memory, -0.60 for executive functions, and 0.72 for global intellectual efficiency. The clinician-guided algorithm demonstrated 94.4% ± 3.8% sensitivity and 80.5% ± 8.7% specificity, and the machine learning classifier 96.8% ± 3.9% sensitivity and 90.7% ± 5.8% specificity. The acceptability of SCD-T was good to excellent. CONCLUSIONS We demonstrate the high accuracy of SCD-T in screening cognitive disorders and its good acceptance even in individuals with prodromal and mild dementia stages. SCD-T would be useful in primary care to faster refer subjects with significant cognitive impairment (and limit unnecessary referrals) to specialized consultation, improve the AD care pathway and the pre-screening in clinical trials.
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Affiliation(s)
- Constance Lesoil
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
| | - Stéphanie Bombois
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
- INSERM U1171 - Degenerative and Vascular Cognitive Disorders, University of Lille, Lille, France
| | - Octave Guinebretiere
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
| | - Marion Houot
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
- Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France
| | - Mahsa Bahrami
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
| | - Marcel Levy
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
| | - Rémy Genthon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
| | - Frédérique Bozon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
| | | | - Stéphane Epelbaum
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
- Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France
| | | | - Nicolas Villain
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France
- Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France
- Sorbonne Université, INSERM U1127, CNRS 7225, Paris, France
| | - Bruno Dubois
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France.
- Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France.
- Sorbonne Université, INSERM U1127, CNRS 7225, Paris, France.
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Vellani S, Puts M, Iaboni A, McGilton KS. Voice your values, a tailored advance care planning intervention in persons living with mild dementia: A pilot study. Palliat Support Care 2022;:1-9. [PMID: 35481452 DOI: 10.1017/S1478951522000475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In the early stage of dementia, persons living with dementia (PLwD) can identify their values and wishes for future care with a high degree of accuracy and reliability. However, there is a paucity of research to guide best practices on how best to incorporate advance care planning (ACP) in older adults diagnosed with mild dementia and therefore only a minority of these individuals participate in any ACP discussions. We developed an intervention called Voice Your Values (VYV) that healthcare professionals can implement to identify and document the values of PLwD and their trusted individuals such as friends or family. PURPOSE This single-group pre-test and post-test design aimed to determine the feasibility, acceptability, and preliminary efficacy of the VYV intervention. METHODS A convenience sample of 21 dyads of PLwD and their trusted individuals were recruited from five outpatient geriatric clinics. The tailored VYV intervention was delivered to the dyads over two sessions using videoconferencing. RESULTS In terms of feasibility, the recruitment rate was lower (52%) than the expected 60%; the retention rate was high at 94%, and the intervention fidelity was high based on the audit of 20% of the sessions. In terms of preliminary efficacy, PLwD demonstrated improvement in ACP engagement (p = <0.01); trusted individuals showed improvements in decision-making confidence (p = 0.01) and psychological distress (p = 0.02); whereas a minimal change was noted in their dementia knowledge (p = 0.22). CONCLUSION Most of the feasibility parameters were met. A larger sample along with a control group, as well as a longitudinal study, are requisite to rigorously evaluate the efficacy of the promising VYV intervention. There is emerging evidence that people living with mild dementia can effectively participate in identifying and expressing their values and wishes for future care.
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Bruderer-Hofstetter M, Dubbelman MA, Meichtry A, Koehn F, Münzer T, Jutten RJ, Scheltens P, Sikkes SAM, Niedermann K. Cross-cultural adaptation and validation of the Amsterdam Instrumental Activities of Daily Living questionnaire short version German for Switzerland. Health Qual Life Outcomes 2020; 18:323. [PMID: 33008394 PMCID: PMC7530958 DOI: 10.1186/s12955-020-01576-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/23/2020] [Indexed: 01/18/2023] Open
Abstract
Background Instrumental Activities of Daily Living (IADL) limitations are associated with reduced health-related quality of life for people with mild cognitive impairment (MCI). For these people, the assessment of IADL is crucial to the diagnostic process, as well as for the evaluation of new interventions addressing MCI. The Amsterdam IADL Questionnaire Short Version (A-IADL-Q-SV) is an established assessment tool with good psychometric properties that has been shown to be robust to cultural differences in Western countries. The aims of this study were to: (1) cross-culturally adapt and validate the A-IADL-Q-SV for the German-speaking population of Switzerland; (2) investigate its cultural comparability; and (3) evaluate further psychometric properties. Methods The A-IADL-Q-SV German was pretested on clinicians and participants in a memory clinic setting. The psychometric properties and cultural comparability of the questionnaire were investigated in memory clinic settings including participants with MCI or mild dementia, as well as participants with normal cognition recruited from the community. Item response theory (IRT) was applied to investigate measurement invariance by means of differential item functioning to assess item bias. Additionally, the test–retest reliability on scale level, the construct validity through hypothesis testing and the discriminant validity of the A-IADL-Q-SV German were evaluated. Results Ninety-six informants of participants with normal cognition, MCI or mild dementia completed the A-IADL-Q-SV German. The basic assumptions for IRT scoring were met. No meaningful differential item functioning for culture was detected between the Swiss and Dutch reference samples. High test–retest reliability on scale level (ICC 0.93; 95% CI 0.9–0.96) was found. More than 75% of the observed correlations between the A-IADL-Q-SV German and clinical measures of cognition and functional status were found to be in the direction and of the magnitude hypothesized. The A-IADL-Q-SV German was shown to be able to discriminate between participants with normal cognition and MCI, as well as MCI and mild dementia. Conclusions The A-IADL-Q-SV German is a psychometrically robust measurement tool for a Swiss population with normal cognition, MCI and mild dementia. Thus, it provides a valuable tool to assess IADL functioning in clinical practices and research settings in Switzerland. Trial registration This study was registered retrospectively in July 2019 on ClinicalTrials.gov (NCT04012398).
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Mark A Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - Florian Koehn
- Geriatrische Klinik St. Gallen, St. Gallen, Switzerland
| | - Thomas Münzer
- Geriatrische Klinik St. Gallen, St. Gallen, Switzerland.,Department of Geriatrics and Aging Research, University Hospital and University of Zurich, Zurich, Switzerland
| | - Roos J Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Karin Niedermann
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
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Tulliani N, Bissett M, Bye R, Chaudhary K, Fahey P, Liu KPY. The efficacy of cognitive interventions on the performance of instrumental activities of daily living in individuals with mild cognitive impairment or mild dementia: protocol for a systematic review and meta-analysis. Syst Rev 2019; 8:222. [PMID: 31462306 PMCID: PMC6712731 DOI: 10.1186/s13643-019-1135-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 08/13/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Cognitive changes associated with mild cognitive impairment or mild dementia can lead to difficulties in completing instrumental activities of daily living. The ability to live independently at home and in the community is often compromised due to the inability to complete these activities. Cognitive interventions have been reported as beneficial in maintaining or improving cognitive functions among this group of adults. However, the effectiveness of different types of cognitive interventions on the performance of instrumental activities of daily living in older adults with mild cognitive impairment and mild dementia is not well established. The aim of this paper is to develop a protocol for a systematic review and meta-analysis to investigate the effectiveness of cognitive interventions in maintaining or improving the performance of instrumental activities of daily living in individuals with mild cognitive impairment or mild dementia. METHODS Randomised control studies which investigate the effectiveness of cognitive interventions on the performance in instrumental activities of daily living for older adults with mild cognitive impairment and mild dementia will be sought. A systematic search will be conducted in five databases: CINAHL, MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials. The search strategy was developed with assistance from a health science librarian. Two independent reviewers will perform the study selection and data extraction. Quality assessment will be implemented using the Physiotherapy Evidence Database (PEDro) scale. A narrative synthesis of the findings will be used to report outcomes of all included studies. If appropriate, a meta-analysis will combine the results of individual studies. DISCUSSION This systematic review and meta-analysis will determine the effectiveness of cognitive interventions in maintaining or improving the performance of IADL in individuals with MCI or mild dementia. It is anticipated that the results will inform rehabilitation professionals of the most effective cognitive interventions to be implemented into clinical practice. It will potentially provide substantial benefit to both the persons with MCI or dementia and the health care system by keeping more people out of full-time care and allowing those in full-time care to require less intensive support. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016042364.
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Affiliation(s)
- Nikki Tulliani
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
| | - Michelle Bissett
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Rosalind Bye
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
| | - Katrina Chaudhary
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
| | - Paul Fahey
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
| | - Karen P Y Liu
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia.
- Translation Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
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Choi MR, Kim JY, Yi ES. Development and validation of exercise rehabilitation program for cognitive function and activity of daily living improvement in mild dementia elderly. J Exerc Rehabil 2018; 14:207-212. [PMID: 29740553 PMCID: PMC5931155 DOI: 10.12965/jer.1836176.088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 04/05/2018] [Indexed: 11/22/2022] Open
Abstract
We investigated the effect of exercise rehabilitation based on fine motor movement for the elderly with mild dementia. Using electroencephalogram (EEG), the change of brain wave of them based on fine motor movement and comparing the improvement level of cognitive ability and performance capability in daily living activity was recorded. The subjects were the elderly with mild dementia living in a sanatorium in Incheon city. Mini-Mental Status Examination, activity of daily living (ADL), and the influence on depression were examined. After 8-week exercise program, significant difference in cognitive function and ADL was observed, however, and there was no significant difference in depression. In the EEG, there was a significant difference in α-wave. This study suggests the chance to remind the necessity of exercise programs for improving cognitive function and ADL of the elderly with dementia.
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Affiliation(s)
- Mi-Ri Choi
- Department of Exercise Rehabilitation & Welfare, College of Health Science, Gachon University, Incheon, Korea
| | - Ji-Youn Kim
- Exercise Rehabilitation Convergence Institute, Gachon University, Incheon, Korea
| | - Eun-Surk Yi
- Department of Exercise Rehabilitation & Welfare, College of Health Science, Gachon University, Incheon, Korea
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Lim YY, Villemagne VL, Laws SM, Pietrzak RH, Ames D, Fowler C, Rainey-Smith S, Snyder PJ, Bourgeat P, Martins RN, Salvado O, Rowe CC, Masters CL, Maruff P; AIBL Research Group. Performance on the Cogstate Brief Battery Is Related to Amyloid Levels and Hippocampal Volume in Very Mild Dementia. J Mol Neurosci 2016; 60:362-70. [PMID: 27586003 DOI: 10.1007/s12031-016-0822-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
Abstract
In a group of older adults with very mild dementia, we aimed to characterize the nature and magnitude of cognitive decline as measured by the Cogstate Brief Battery, in relation to Aβ levels and hippocampal volume. Participants were characterized according to their status on the Clinical Dementia Rating (CDR) scale. A total of 308 individuals who were CDR 0 and had low cerebral Aβ levels (Aβ-), 32 individuals who were Aβ- and CDR 0.5, and 43 individuals who were Aβ+ and CDR 0.5 were included in this study. Participants completed the CogState brief battery at baseline, and at 18-, 36-, 54- and 72-month follow-up. Linear mixed model analyses indicated that relative to the Aβ- CDR 0 group, the Aβ+ CDR 0.5 group showed increased rates of memory decline and hippocampal volume loss. However, compared to the Aβ- CDR 0 group, the Aβ- CDR 0.5 group showed no changes in cognitive function or hippocampal volume over 72 months. The results of this study confirm that in individuals with very mild dementia, who also have biomarker confirmation of Aβ+, changes in cognitive function manifest primarily as deterioration in memory processing, and this is associated with hippocampal volume loss. Conversely, the absence of any cognitive decline or loss in hippocampal volume in individuals with very mild dementia but who are Aβ- suggests that some other non-AD disease process may underlie any static impairment in cognitive function.
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Petrova M, Mehrabian-Spasova S, Aarsland D, Raycheva M, Traykov L. Clinical and Neuropsychological Differences between Mild Parkinson's Disease Dementia and Dementia with Lewy Bodies. Dement Geriatr Cogn Dis Extra 2015. [PMID: 26195977 PMCID: PMC4483490 DOI: 10.1159/000375363] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The specific profile of dementia in Parkinson's disease (PDD) and dementia with Lewy bodies (DLB) in the earliest stages of dementia is still unclear and subject of considerable controversy. METHODS We investigated 27 PDD patients and 24 DLB patients with parkinsonism in the early stage of dementia, i.e. with a Mini-Mental State Examination score of ≥24. RESULTS Compared to PDD, patients with DLB demonstrated significantly lower scores when testing attention and executive functions [modified card sorting test (p < 0.001) and digit span backward (p < 0.02)], as well as when testing constructive abilities [copy of complex designs (p = 0.001) and pentagon (p < 0.001)]. Using logistic regression analysis, diagnosis was predicted from the cognitive profile, with an overall accuracy of 88.2%. In addition, PDD patients showed a significantly higher Unified Parkinson's Disease Rating Scale (UPDRS) motor subscore (p < 0.001) as well as higher UPDRS motor item scores [tremor at rest (p = 0.01) and bradykinesia (p = 0.001)]. CONCLUSIONS The cognitive profile in PDD differs from that in DLB in the early stage of dementia, with worse performance on tests of attention and executive functions and constructive abilities in DLB compared to PDD patients. In contrast, motor symptoms are more severe in PDD than in DLB.
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Affiliation(s)
- Mariya Petrova
- Department of Neurology, University Hospital 'Alexandrovska', Sofia, Bulgaria
| | | | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden ; Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Margarita Raycheva
- Department of Neurology, University Hospital 'Alexandrovska', Sofia, Bulgaria
| | - Latchezar Traykov
- Department of Neurology, University Hospital 'Alexandrovska', Sofia, Bulgaria
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